<snip>

"Welcome to the club no one wants to join" :-)

Very common in the early stages, read it here all the time, often relatives
dont believe it because they are with the person only for 10 minutes or an
hour or however long they can 'hold it together', especially on the phone.
Even when my father was pretty far gone he could still hold it together well
enough to fool people, he nearly had a neighbour phoning the police because
his 'sister (actually his wife, my mother) was insisting he went into a
home. His 'wife' had died some years ago, aparently, but he said it all well
enough he was believed by the guy. And you could hold a rational
conversation with him..though if you waited 10 minutes (now its 10 seconds)
you could hold the exact same rational conversation again!

Dont think of it as being deliberate to annoy you, they are just
unconsciously doing the best they can to overcome their handicap. She also
quite possibly wont be aware anything is wrong, the strange explanations she
comes up with are the only things that make sense when everything else is
eliminated,and very few people will accept a diagnosis of mental incapacity
even if its their diagnosis. As my father once said to me, in one of his
last moments of clarity with me "I know I have a memory problem but I'm not
worried about it because I forget I have it".

The only way to make an outsider who hasnt experienced this, say a relative,
understand, is to leave them to care for the person all day long. This will
cure your siblings very quickly! You must, for the sake of your sanity, get
one of your siblings to care for her for an extended period so she cant keep
the pretence up...a weekend would be perfect, or even a week. If you have to
give them ultimatums, so be it, most of us here get to that point sooner or
later. I say one sibling, because if several look after her, then they miss
out on the concentrated behaviour, each one is only with her for an hour or
two, so they only see a repitition two or three times, not 5 or 10 or 100.

You could always set up a video I suppose, just leave it running for hours,
and/or keep a diary, if you need to show it to a doctor. Dont put emotions
in it, just factually state what happened, at what time.

=================================
Absolutely! When my MIL was in the beginning
stages she had almost everyone fooled.

Unless you are around the person almost constantly...
you will not realize how bad the situation is.

Violet asked if people with early stage dementia conceal their
condition at will from outsiders?

Mary responds: Yes, absolutely. A lot also depends on what the outsider
expects or wants to see, and that includes friends and family members
who WANT the person to be who they've always been.

Think about the typical social interaction. You don't ask a lot of
specific questions, you don't leave and go and check up on what they've
told you for accuracy and truth. A social conversation is relatively
empty. The person can get away without imparting specifics.

My mother in laws personality was intact long into her illness. She was
a nice looking lady with a pleasant manner. People liked her. She was
not well educated, and she was aways a little fluffy and vague - and
tended to be very self depreciating. It was a great weapon against
detection.

I was the one who first realized there was something going on - minor
memory problems were the first thing I noticed - such as forgetting to
completely set the table for dinner, calling me a half dozen times to
confirm when we were coming over - totally small things that she could
efffectively cover for (oh dear, silly me, of course you told me you
were coming at 3....or, oh my goodness, oh look at that, I bought buns
and forgot to put them out!" She was also good at giving off the signal
that she was embarrassed about something, so if a line of questioning
was making her uncomfortable, people who knew her would back right off
(and thus not interrogate her to the point they might realize that she
couldn't remember attending their son's wedding three months ago AT
ALL). She also started avoiding many demanding situations, but she had
a couple of minor health problems, so she used those an excuse.
Hindsight is always 20-20. I recall in particular her being taken to a
bridal shower (both bride and groom were children of close friends and
neighbours). Everyone thought she'd have a lovely time. However, she
was VERY upset afterwards - they had been playing those silly shower
games, and she couldn't catch on to the rules or follow what was going
on, so she felt embarrassed and confused. At the time she blamed her
poor hearing....but that wasn't the problem at all.

She had pernicious anemia, and following some cataract surgery, she
neglected to go for her B12 shot for a couple of months, mostly because
she couldn't drive. When I found out, I was a little stern with her,
realizing that she MUST have those shots, and told her of course we'd
drive her, or arrange for cabs, whatever. I presumed the memory
problems might be related to the B12 problem, and mentioned it to the
doctor when I took her over (he was/is my doctor as well and had known
her for years and years). He told me he didn't think there was anything
wrong with her, but he'd do some checking. He went in with her, and
came out ashen. She was perfectly able to answer questions about
herself, current events etc. but when he asked her to do some clock
face tests and copy some line drawings, there was clearly something
very, very wrong (they clearly indicated disorganized thinking, which
alarmed me much more than mere memory concerns).

Once we knew this, we stopped being accepting of her vague explanations
and various ways of putting us off the trail. In other words, we got
very suspicious and started checking up on everything she told us,
looking through her papers, etc. and found lots of evidence that
something was askew. For example, her bookkeeping for my father in
law's estate had gone completely kerflewy. The financial planner we had
take over her taxes and other finances later noted that my mother in
law had kept perfect books until about six months before I spoke to the
doctor - and after that point, things got more and more ragged until
they were in a total snarl as her ability to understand numbers and do
basic math had been lost.

Her diagnosis was delayed by a broken hip, but when we did get in to
see the geriatric dementia specialist (who was a psychiatrist), part of
the work up included a battery of cognitive tests, not unlike what
you'd put a kid through to look for learning problems - little puzzles,
exercises in logic, copying drawings, etc. She was very upset about
what she thought were silly tests, so my husband (her only child) went
with her, and sat with her through the testing. Here were very
definitive tests, and she couldn't hide behind amount of charm, no
amount of diversion or distraction, subject changing, self
depreciation, jokes etc. And she did try. She was insulted by the idea
that she might be impaired. The psychometrist was very reassuring to
her, but  but my husband was completely shocked - because the deficits
were so stunningly overt.

It was actually a huge help, since it helped us understand at ground
level what we were up against - not just memory, but the undoing of her
entire mind, from the foundation up. Her ability to reason and follow
logic, to understand sequences, cause and effect, her understanding and
"feel" for time, her judgement - all very seriously impaired, at a time
where had you met her, you would not have believed there was a thing
wrong with her.  Having those test results also gave us the confidence
to do what needed doing, and move ahead with plans and supports for
her, despite the constant barrage of criticism and interference from
her friends, neighbours and other family, who thought there was nothing
wrong with her, and that we were mean and rotten.

I'd strongly urge you to have some cognitive tests done to determine
the extent of her deficits and also define their nature. It will help
you understand the behaviours you may see and get your own head around
the challenges you face. It will give you the ammunication to deal with
the naysayers.

Mary

Absolutely! My mother is now in later stages of Alzheimer's, so there is no
hiding it, but in the early days, she was very adept at hiding it from everyone
and insisted, even when it was clear that something was wrong - such as the
first time she claimed that the TV was 2 way and that the people were talking to
her and could see and hear her - she was terribly upset if anyone suggested that
she was not okay. When she was tested at the doctor, she blamed my father and
sister for the fact that she had to undergo the "humiliating" test and refused
to speak to them for days. For some reason, I was not blamed for being a party
to the testing, but I did get the brunt of some of her protestations.
She hid her dementia very well for a few years, it seems. Now, several years
later, there are things that I realize could have clued us in sooner, but we
just assumed her forgetfulness was normal aging and that some of the other signs
were "normal" as she was always creative and a bit eccentric.
-steve